Active NPI
Justin Jun-Young Cheng
- Geriatric Medicine (Internal Medicine) Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- A180909
- Practice address
- 11301 Wilshire Blvd
Los Angeles, CA 90073-1003 - Phone
- (310) 478-3711
- NPI assigned
- Mar 18, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | A180909 | CA | Primary |
Addresses
Primary practice location
11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Mailing address
11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone (310) 478-3711
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A180909 | CA | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Memorial Medical Group Inc | Past | Accepting new patients |
Locations
1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000
5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864
824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706
797 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 535-2434
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611
888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400
5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1659312593
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Durable Medical Equipment & Medical Supplies
- Murrieta, CA
- NPI 1760057269
-
- Health Maintenance Organization
- Northridge, CA
- NPI 1013409036
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Durable Medical Equipment & Medical Supplies
- Phoenix, AZ
- NPI 1255523643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1114486255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003",
"telephone_number": "310-478-3711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003",
"telephone_number": "310-478-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENG",
"first_name": "JUSTIN",
"middle_name": "JUN-YOUNG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-18",
"last_updated": "2024-05-07",
"certification_date": "2023-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "CA",
"license": "A180909",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "5601 De Soto Ave",
"city": "Woodland Hills",
"state": "CA",
"country_code": "US",
"postal_code": "913676701",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.